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10. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils:11. <br />Three compartment sink. <br />OR <br />Detergentfbleach, and wiping cloths (cleaning towels). <br />□ Tub to store wiping cloths in bleach solution. <br />12. <br />13. <br />■ V <br />Title Date <br />Paper Hand Towels <br />Cutting Board 1 BleachPropane Stove <br />■ <br />J <br />Propane Tank <br />Bleach and Water <br />Fire Extinguisher0- <br />Page 8 of 11 TEMP EVENT APREHD 16-02 <br />08/01/16 <br />□ Three deep tubs (basins 6-8 inches minimum), one for soapy water, one for rinsing and one for a bleach <br />solution .(one tablespoon of bleach per gallon of water). <br />□ Icejchests <br />0 Refrigerated truck <br />□ Other (specify) <br />0 Refrigerator ' <br />0 Ice bath and tubs <br />5 Gal Hand wash <br />Wastewater Container <br />Garbage <br />Can <br />Sanitizer bucket- <br />Weach & water for <br />storing wiping doths <br />Booth must be on <br />Concrete, Asphalt, <br />Plywood, or a Tarp. <br />5-20 Gal. <br />Hand wash Water <br />Extra <br />Water <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />. ■.' *•- <br />Ice Cooler I J <br />J \ <br />Stemo w/Chaffing • <br />Dish <br />Signature <br />Exfra /ce Bags & Food Containers must be <br />stored 6 Inches off of the ground! <br />• 146—___r._. <br />| Health Permit |SC-; <br />■ -‘>- <br />.. r' <br />■( • <br />Rinse Water <br />□TWater supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />0t5ne^separate tub (bucket or basin) for the collection of rinse/wastewater. <br />LZTPaper towels and p'ump^style soap container. <br />Names of Sponsible persons to be present in booth during all hours of operation: <br />' X__ _________________________ <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45°F (if food is used the following day, maintain below 41 °F temperature): <br />"‘■Important** All fodti vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this event. A copy of this checklist must be in the booth at all hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />this event. <br />Soap and Water <br />■F <br />•* <br />Soap dispenser j --------- - <br />Ho <br />^Complet^b^